Ecuavet Veterinary Services in Quito, Ecuador

In this installment of Practice Profile, Ellen F. K. van Nierop de Fierro, DVM describes her practices, Ecuavet and Vet2Home, which she co-owns with her husband, Dr. Germán Fierro, in Quito, Ecuador.

My husband and I, both veterinarians, own a small animal practice. Our main clinic is situated in a suburb of Quito, Ecuador. We also have an auxiliary clinic and a pet hotel on the property where we live. Our team includes four veterinarians, three assistants, and one receptionist. Because veterinary nurses or technicians are not available in Ecuador, we train our assistants to do basic cleaning and handling.

All medical and diagnostic procedures are done by our veterinarians. It is normal for most veterinary centers, like ours, to offer grooming, pet shop, pharmacy, and pet hotel services aside from veterinary care; this is an important source of income.

Our practice would be considered an above average facility in Ecuador; it includes blood chemistry and hematology machines, a surgery room, and radiograph and ultrasound equipment. The price for the use of these diagnostic machines is relatively high because of import tax, high maintenance costs (some maintenance is required outside the country), and the low number of clients accepting these tests making the overhead more expensive. There is one specialized laboratory for veterinary samples in Quito, where we send samples we cannot do in house. Until recently we did not have any veterinary histology.

In Ecuador people generally believe in keeping things as natural as possible, and neutering a dog is seen as unnatural. The many stray dogs show the result of that and keep the prevalence of Parvo and Distemper viruses high. Rabies is a concern outside the major cities, and free vaccinations against rabies and yearly vaccination campaigns are organized by the government. Puppies are often acquired for a pleading child or given away as party prizes and then cast out when housebreaking does not quite work on its own.

Pediatricians often advise owners to get rid of pets when a woman is pregnant or a baby is born. The willingness and the ability of clients to pay for health services varies. Willingness is often related to how apparent the results are. The number of people who want their dog groomed, but do not have money to pay for vaccinations is frustrating.

We spend at least 50% of each consultation on client education. We need to justify exactly why we need each test, instead of just doing a CBC and chemistry without really knowing what we are looking for. We are reminded daily to treat the dog, not the lab results. Some small animal medication is available, but we use a lot of human use drugs because of price and availability.

There is a problem in getting certain drugs, such as analgesics, anesthetics, and endocrine medications. Typical cases include dermatology, GI disorders, wounds, mammary gland tumors, intoxications, and respiratory problems.

The lack of referral centers and specialists makes veterinary medicine extremely challenging. We cannot send difficult cases elsewhere; we make do on our own and call in the few specialists we have (all trained outside of Ecuador). Although satisfying to find solutions to problems just beyond our reach and with limited resources, it is at least equally frustrating, when things don ́t work out, to know that in other parts of the world you might have been able to save the patient.

There are no specialist courses in Ecuador, and most CE is in English and relatively expensive. We get our CE from WSAVA and FIAVAC courses, and some Spanish online courses.

Our clinics sometimes welcome international veterinarians, often fresh out of school, who want to travel through one of the most biodiverse countries on earth and learn about veterinary care here. By inviting them to be a part of our team for a time, we are updated on the newest trends at universities abroad, and they are introduced to the casuistry and basic diagnostic techniques of a developing country.

Happily pets are moving up the social ladder in Ecuador. When I first came here and asked for blood work, clients would laugh and say it was only a dog, and they would not go as far as taking blood samples. Now, twelve years later, it is a common procedure, although not all pet owners can afford it.